The 7th Joint Session between JDDW-KDDW-TDDW3(JDDW)
Thu. November 2nd   9:00 - 12:00   Room 10: Portopia Hotel Waraku
Current status and future perspectives of Interventional EUS in Asia focused on EUS-guided gallbladder drainage in South Korea
Se Woo Park
Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine
Laparoscopic cholecystectomy is considered the standard and preferred treatment for acute cholecystitis (AC). However, this surgical option may not be suitable for certain patients who are not ideal candidates for surgery due to various factors. Recently, endoscopic ultrasound (EUS)-guided gallbladder (GB) drainage (EUS-GBD) represents a potentially disruptive technology, as it offers a less invasive alternative to traditional surgical approaches. As a result, therapeutic strategies are experiencing a notable paradigm shift, leaning towards minimally invasive treatments. While the field is continuously evolving, several devices and techniques are currently being developed to facilitate easier and safer procedures for EUS-GBD. Indeed, recent innovations in the field of EUS-GBD, such as the lumen-apposing metal stents (LAMSs) with bidirectional anchoring flanges, have significantly improved outcomes for patients requiring drainage. Additionally, the use of LAMS has proven to be not only safe and reliable for cases of acute cholecystitis but also beneficial in enhancing the quality of life for patients who may not be ideal candidates for surgical treatment.
As an endosonographer performing EUS-GBD, there are several questions and uncertainties surrounding this procedure. Some of the key questions include:
1. Optimal Patient Selection: What are the specific criteria for identifying the most suitable candidates for EUS-GBD? Which patients are likely to benefit the most from this procedure compared to other treatment options?
2. Long-term Management: What are the long-term outcomes and potential complications associated with EUS-GBD?
3. Stent Selection: What factors should be considered when selecting the appropriate stent for EUS-GBD?
4. Comparisons with Surgical Options: How do the outcomes of EUS-GBD compare to traditional surgical interventions, such as laparoscopic cholecystectomy, in terms of efficacy, safety, and patient satisfaction?
5. Timing of Intervention: In what situations is EUS-GBD best utilized as a definitive treatment, and when is it more appropriate as a bridging therapy until surgical options become feasible?
6. Complication Management: How should potential complications, such as bile reflux, stent migration, or food impaction, be managed in patients undergoing EUS-GBD?
7. Future Developments: What ongoing research and technological advancements are being pursued to further improve the efficacy, safety, and overall outcomes of EUS-GBD?
Addressing these questions through further research, collaboration among endosonographers, and shared experiences will contribute to a deeper understanding and optimization of EUS-GBD as a valuable therapeutic option for patients.
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